磁共振平面测量法和磁共振帕金森综合征指数在鉴别帕金森病和进行性核上性麻痹中的作用：一项基于1.5T和3T磁共振成像的回顾性研究
Role of magnetic resonance planimetry and magnetic resonance parkinsonism index in discriminating Parkinson's disease and progressive supranuclear palsy: a retrospective study based on 1.5 and 3 T MRI.
作者信息
Nizamani Waseem Mehmood, Mubarak Fatima, Barakzai Muhammad Danish, Ahmed Muhammad Saad
机构信息
Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan.
Department of Radiology, Ziauddin University Hospital, Karachi, Pakistan.
出版信息
Int J Gen Med. 2017 Oct 31;10:375-384. doi: 10.2147/IJGM.S134297. eCollection 2017.
OBJECTIVE
The objective of the study was to assess magnetic resonance (MR) planimetric measurements and MR parkinsonism index (MRPI) in differentiating progressive supranuclear palsy (PSP) from Parkinson's disease (PD) using 1.5 and 3 T MRI scanner.
SUBJECTS AND METHODS
After ethical approval was obtained, analysis of 34 consecutive patients with PSP, 34 patients with PD and 34 healthy controls (HCs) was performed. HCs were age-matched adults without any history of neurodegenerative disease or movement disorders. Retrospective data from the past 10 years (from January 2006 to December 2015) were obtained from the Hospital Information Management System, and informed consent was obtained from all participants. The measurements of pons area-midbrain area ratio (P/M) and MCP width-superior cerebellar peduncle (SCP) width ratio (MCP/SCP) were used, and MRPI was calculated by the formula ([P/M]×[MCP/SCP]).
RESULTS
Midbrain area and SCP width in patients with PSP (19 males, 15 females; mean age =66.7 years) were significantly (<0.001) smaller than in patients with PD (20 males, 14 females; mean age =66.7 years) and control participants (17 males, 17 females; mean age =66.1 years). P/M and MCP/SCP were significantly higher in patients with PSP than in patients with PD and control participants. All measurements showed some overlap of values between patients with PSP and patients from PD group and control participants. MRPI value was significantly higher in patients with PSP (mean 21.00) than in patients with PD (mean 9.50; <0.001) and control participants (mean 9.6; <0.001), without any overlap of values among groups. No correlation was found between the duration of disease, PSP rating scale, PSP staging system and MRPI in this study. No patient with PSP received a misdiagnosis when the index was used (sensitivity and specificity, 100%).
CONCLUSION
MRPI should be made an essential part of all MRI brain reporting whenever differentiation between PD and PSP is sought for.
目的
本研究的目的是使用1.5和3T磁共振成像（MRI）扫描仪，评估磁共振（MR）平面测量和MR帕金森综合征指数（MRPI）在区分进行性核上性麻痹（PSP）与帕金森病（PD）中的作用。
对象与方法
在获得伦理批准后，对34例连续的PSP患者、34例PD患者和34名健康对照者（HCs）进行分析。HCs为年龄匹配的成年人，无任何神经退行性疾病或运动障碍病史。从医院信息管理系统获取过去10年（2006年1月至2015年12月）的回顾性数据，并获得所有参与者的知情同意。采用脑桥面积与中脑面积比值（P/M）和脑桥基底部宽度与上小脑脚宽度比值（MCP/SCP）进行测量，并通过公式（[P/M]×[MCP/SCP]）计算MRPI。
结果
PSP患者（19例男性，15例女性；平均年龄=66.7岁）的中脑面积和上小脑脚宽度显著（<0.001）小于PD患者（20例男性，14例女性；平均年龄=66.7岁）和对照参与者（17例男性，17例女性；平均年龄=66.1岁）。PSP患者的P/M和MCP/SCP显著高于PD患者和对照参与者。所有测量结果显示PSP患者与PD组患者及对照参与者之间存在一些数值重叠。PSP患者的MRPI值（平均21.00）显著高于PD患者（平均9.50；<0.001）和对照参与者（平均9.6；<0.001），各组间数值无重叠。本研究未发现疾病持续时间、PSP评定量表、PSP分期系统与MRPI之间存在相关性。使用该指数时，无PSP患者被误诊（敏感性和特异性均为100%）。
结论
每当需要区分PD和PSP时，MRPI应成为所有脑部MRI报告的重要组成部分。
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